title: Remote ischaemic preconditioning down-regulates kinin receptor expression in neutrophils of patients undergoing heart surgery.
abstract: OBJECTIVE
  Remote ischaemic preconditioning (RIPC) may protect distant organs against ischaemia-reperfusion injury. We investigated the impact of RIPC on kinin receptor expression in neutrophils following RIPC in patients undergoing coronary artery bypass grafting (CABG).
  
  
  METHODS
  Patients undergoing elective CABG with cardiopulmonary bypass (CPB) were randomized to RIPC (n = 15) or control (n = 15) groups. The study group underwent RIPC by inflation of a blood pressure cuff on the arm. Expression of kinin receptors, plasma concentrations of IL-6, IL-8, IL-10, TNF-α and neutrophil elastase were determined at baseline (before RIPC/sham), immediately before surgery (after RIPC/sham) and 30 min and 24 h after surgery. Plasma bradykinin levels were assessed before and after RIPC/sham, and at 30 min, 6, 12 and 24 h after surgery. Serum creatine kinase (CK), troponin I, C-reactive protein (CRP) and lactate levels were measured immediately prior to surgery and 30 min, 6, 12, 24 and 48 h after surgery.
  
  
  RESULTS
  Kinin B2 receptor expression did not differ between the groups at baseline (pre-RIPC), but was significantly lower in the RIPC group than in the control group after RIPC/sham (P < 0.05). Expressions of both kinin B1 and B2 receptors were significantly down-regulated in the RIPC group, and this persisted to 24 h after surgery (P < 0.001). Neutrophil elastase levels were significantly increased after surgery. There were no differences in CK, CRP, cytokine, lactate or troponin I levels between the groups.
  
  
  CONCLUSIONS
  RIPC down-regulated the expression of kinin B1 and B2 receptors in neutrophils of patients undergoing CABG.
authors.affiliation: School of Surgery, University of Western Australia, Perth, Australia.
authors.forename: Pankaj
authors.initials: P
authors.lastname: Saxena
authors.forename: Shashi
authors.initials: S
authors.lastname: Aggarwal
authors.forename: Neil L
authors.initials: NL
authors.lastname: Misso
authors.forename: Jurgen
authors.initials: J
authors.lastname: Passage
authors.forename: Mark A J
authors.initials: MA
authors.lastname: Newman
authors.forename: Philip J
authors.initials: PJ
authors.lastname: Thompson
authors.forename: Yves
authors.initials: Y
authors.lastname: d'Udekem
authors.forename: Slavica
authors.initials: S
authors.lastname: Praporski
authors.forename: Igor E
authors.initials: IE
authors.lastname: Konstantinov
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D001920:Bradykinin / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism; D002315:Cardiopulmonary Bypass; D001026:Coronary Artery Bypass / Q000009:adverse effects; D003402:Creatine Kinase / Q000097:blood; D016207:Cytokines / Q000097:blood; D004311:Double-Blind Method; D015536:Down-Regulation; D005260:Female; D006801:Humans; D019194:Ischemic Preconditioning / Q000379:methods*; D019344:Lactic Acid / Q000097:blood; D019272:Leukocyte Elastase / Q000097:blood; D008297:Male; D008875:Middle Aged; D009504:Neutrophils / Q000378:metabolism*; D011446:Prospective Studies; D043783:Receptor, Bradykinin B1 / Q000378:metabolism*; D043782:Receptor, Bradykinin B2 / Q000378:metabolism; D012039:Regional Blood Flow; D015427:Reperfusion Injury / Q000097:blood / Q000209:etiology / Q000517:prevention & control*; D013997:Time Factors; D014111:Tourniquets; D016896:Treatment Outcome; D019210:Troponin I / Q000097:blood; D034941:Upper Extremity / Q000098:blood supply*; D014904:Western Australia
chemical_list: D015415:Biomarkers; D016207:Cytokines; D043783:Receptor, Bradykinin B1; D043782:Receptor, Bradykinin B2; D019210:Troponin I; D019344:Lactic Acid; D002097:C-Reactive Protein; D003402:Creatine Kinase; D019272:Leukocyte Elastase; D001920:Bradykinin
keywords: Bradykinin; Cardiac surgery; Ischaemia; Ischaemic preconditioning; Kinin receptors